Contract Pharmacy Details

CVS ALBANY, L.L.C.
DSH330080 LINCOLN MEDICAL & MENTAL HEALTH CENTER (NYCHHC)

Covered Entity Details

Entity Name

LINCOLN MEDICAL & MENTAL HEALTH CENTER (NYCHHC)

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH330080

Entity Address

234 EAST 149TH ST
BRONX, NY 10451

Medicare Provider Number

330080

Participating Start Date

12/1/1992

Last Recertification Date

9/4/2024

Pharmacy Details

Pharmacy Name

CVS ALBANY, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 05772
1500 LEXINGTON AVE.
NEW YORK, NY 10029

Pharmacy Comments

Contract Details

Approval Date

6/25/2020

Contract Begin Date

7/1/2020

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Paul Albertson, Vice President
(212) 748-2256

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

6/25/2020

340B Drug Pricing Program Database